{"id":3972,"date":"2025-01-08T19:15:35","date_gmt":"2025-01-08T13:45:35","guid":{"rendered":"https:\/\/indianlawsociety.com\/?p=3972"},"modified":"2025-01-14T09:34:32","modified_gmt":"2025-01-14T04:04:32","slug":"ayushman-bharat-a-comprehensive-overview-of-indias-flagship-healthcare-scheme","status":"publish","type":"post","link":"https:\/\/karma.law\/insights\/civil-law-in-india\/health-environmental-law\/ayushman-bharat-a-comprehensive-overview-of-indias-flagship-healthcare-scheme\/","title":{"rendered":"Ayushman Bharat: A Comprehensive Overview of India’s Flagship Healthcare Scheme"},"content":{"rendered":"

Ayushman Bharat, a flagship initiative of the Government of India,<\/a> is a transformative program designed to achieve Universal Health Coverage (UHC). Launched as recommended by the National Health Policy 2017, Ayushman Bharat aims to address healthcare holistically, moving from a fragmented approach to a comprehensive, need-based system. This scheme is structured around two interconnected components: Health and Wellness Centres (HWCs) and Pradhan Mantri Jan Arogya Yojana (PM-JAY).<\/span><\/p>\n

Ayushman Bharat: A Two-Pronged Approach<\/span><\/strong><\/p>\n

Ayushman Bharat adopts a continuum of care approach, focusing on both preventive and curative healthcare. It is comprised of two inter-related components:<\/span><\/p>\n

    \n
  1. \n

    Health and Wellness Centres (HWCs):<\/span><\/strong><\/p>\n

      \n
    • \n

      Transformation of Existing Centers:<\/span><\/strong>\u00a0The government aims to create 150,000 HWCs by transforming existing Sub Centres and Primary Health Centres.<\/span><\/p>\n<\/li>\n

    • \n

      Comprehensive Primary Health Care (CPHC):<\/span><\/strong>\u00a0These centers deliver CPHC, bringing healthcare closer to people’s homes.<\/span><\/p>\n<\/li>\n

    • \n

      Expanded Services:<\/span><\/strong>\u00a0HWCs offer a wide range of services, including maternal and child health services, non-communicable disease care, free essential drugs, and diagnostic services.<\/span><\/p>\n<\/li>\n

    • \n

      Health Promotion and Prevention:<\/span><\/strong>\u00a0They emphasize health promotion and prevention, empowering individuals and communities to choose healthy behaviors and reduce the risk of chronic diseases.<\/span><\/p>\n<\/li>\n<\/ul>\n<\/li>\n

    • \n

      Pradhan Mantri Jan Arogya Yojana (PM-JAY):<\/span><\/strong><\/p>\n

        \n
      • \n

        World’s Largest Health Assurance Scheme:<\/span><\/strong>\u00a0Launched on September 23, 2018, PM-JAY is the world’s largest health assurance scheme, providing a health cover of \u20b95 lakh per family per year for secondary and tertiary care hospitalization.<\/span><\/p>\n<\/li>\n

      • \n

        Targeted Beneficiaries:<\/span><\/strong>\u00a0The scheme covers over 12 crore poor and vulnerable families (approximately 55 crore beneficiaries), representing the bottom 40% of the Indian population.<\/span><\/p>\n<\/li>\n

      • \n

        Socio-Economic Caste Census (SECC) 2011:<\/span><\/strong>\u00a0Beneficiaries are identified based on the deprivation and occupational criteria of the SECC 2011.<\/span><\/p>\n<\/li>\n

      • \n

        Inclusion of RSBY Families:<\/span><\/strong>\u00a0PM-JAY also covers families previously covered under the Rashtriya Swasthya Bima Yojana (RSBY).<\/span><\/p>\n<\/li>\n

      • \n

        Government Funded:<\/span><\/strong>\u00a0PM-JAY is fully funded by the government, with implementation costs shared between the Central and State Governments.<\/span><\/p>\n<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n

        Key Features of PM-JAY:<\/span><\/strong><\/p>\n

          \n
        • \n

          Cashless Access:<\/span><\/strong>\u00a0Provides cashless access to healthcare services at empanelled hospitals.<\/span><\/p>\n<\/li>\n

        • \n

          Financial Protection:<\/span><\/strong>\u00a0Aims to mitigate catastrophic expenditure on medical treatment, which pushes nearly 6 crore Indians into poverty each year.<\/span><\/p>\n<\/li>\n

        • \n

          Pre and Post-Hospitalization Coverage:<\/span><\/strong>\u00a0Covers up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses.<\/span><\/p>\n<\/li>\n

        • \n

          No Restrictions:<\/span><\/strong>\u00a0No restrictions on family size, age, or gender.<\/span><\/p>\n<\/li>\n

        • \n

          Pre-Existing Conditions Covered:<\/span><\/strong>\u00a0All pre-existing conditions are covered from day one.<\/span><\/p>\n<\/li>\n

        • \n

          Portability:<\/span><\/strong>\u00a0Benefits are portable across the country, allowing beneficiaries to avail treatment at any empanelled hospital in India.<\/span><\/p>\n<\/li>\n

        • \n

          Comprehensive Coverage:<\/span><\/strong>\u00a0Includes approximately 1,929 procedures covering all costs related to treatment.<\/span><\/p>\n<\/li>\n

        • \n

          Equitable Reimbursement:<\/span><\/strong>\u00a0Public hospitals are reimbursed at par with private hospitals.<\/span><\/p>\n<\/li>\n<\/ul>\n

          Benefit Cover Under PM-JAY:<\/span><\/strong><\/p>\n

          PM-JAY provides a cashless cover of up to \u20b95 lakh per eligible family per year for listed secondary and tertiary care conditions. The cover includes:<\/span><\/p>\n

            \n
          • \n

            Medical examination, treatment, and consultation.<\/span><\/p>\n<\/li>\n

          • \n

            Pre-hospitalization expenses.<\/span><\/p>\n<\/li>\n

          • \n

            Medicines and medical consumables.<\/span><\/p>\n<\/li>\n

          • \n

            Non-intensive and intensive care services.<\/span><\/p>\n<\/li>\n

          • \n

            Diagnostic and laboratory investigations.<\/span><\/p>\n<\/li>\n

          • \n

            Medical implantation services.<\/span><\/p>\n<\/li>\n

          • \n

            Accommodation benefits.<\/span><\/p>\n<\/li>\n

          • \n

            Food services.<\/span><\/p>\n<\/li>\n

          • \n

            Treatment of complications.<\/span><\/p>\n<\/li>\n

          • \n

            Post-hospitalization follow-up care up to 15 days.<\/span><\/p>\n<\/li>\n<\/ul>\n

            The \u20b95 lakh cover is on a family floater basis, meaning it can be used by one or all family members. There is no cap on family size or age of members, and pre-existing diseases are covered from day one.<\/span><\/p>\n

            Why PM-JAY: A Background<\/span><\/strong><\/p>\n

              \n
            • \n

              Socio-Economic Disparities:<\/span><\/strong>\u00a0Despite economic growth, a significant portion of India’s population lives in poverty, with limited access to affordable healthcare.<\/span><\/p>\n<\/li>\n

            • \n

              Triple Burden of Disease:<\/span><\/strong>\u00a0India faces a “triple burden of disease,” with ongoing communicable diseases, a rising prevalence of non-communicable diseases (NCDs), and injuries.<\/span><\/p>\n<\/li>\n

            • \n

              Healthcare Supply Gap:<\/span><\/strong>\u00a0The public healthcare system is overburdened, while the private sector is largely unregulated and concentrated in urban areas.<\/span><\/p>\n<\/li>\n

            • \n

              Underfunding of Public Health:<\/span><\/strong>\u00a0Government expenditure on health has remained stagnant, leading to high out-of-pocket expenses.<\/span><\/p>\n<\/li>\n

            • \n

              Poverty:<\/span><\/strong>\u00a0High out-of-pocket health expenditure is a leading cause of poverty in India, pushing millions into poverty each year.<\/span><\/p>\n<\/li>\n

            • \n

              Fragmented Health Insurance:<\/span><\/strong>\u00a0Previous government-funded health insurance schemes were fragmented and lacked a link with primary healthcare.<\/span><\/p>\n<\/li>\n<\/ul>\n

              Addressing Challenges Through Ayushman Bharat:<\/span><\/strong><\/p>\n

              To address these challenges, the government adopted a two-pronged approach:<\/span><\/p>\n

                \n
              • \n

                Health and Wellness Centres (HWCs):<\/span><\/strong>\u00a0To focus on disease prevention and health promotion by upgrading existing primary healthcare infrastructure.<\/span><\/p>\n<\/li>\n

              • \n

                Pradhan Mantri Jan Arogya Yojana (PM-JAY):<\/span><\/strong>\u00a0To provide financial protection for hospitalization needs and improve access to quality healthcare.<\/span><\/p>\n<\/li>\n<\/ul>\n

                Coverage under PM-JAY:<\/span><\/strong><\/p>\n

                  \n
                • \n

                  Target Population:<\/span><\/strong>\u00a0PM-JAY targets the bottom 40% of the population, based on the SECC 2011 data.<\/span><\/p>\n<\/li>\n

                • \n

                  Rural Beneficiaries:<\/span><\/strong>\u00a0Rural households are included based on seven deprivation criteria (D1 to D7) and automatic inclusion criteria.<\/span><\/p>\n<\/li>\n

                • \n

                  Urban Beneficiaries:<\/span><\/strong>\u00a0Urban households are categorized based on 11 occupational categories of workers.<\/span><\/p>\n<\/li>\n

                • \n

                  State Flexibility:<\/span><\/strong>\u00a0States can use their own databases for PM-JAY, ensuring all families eligible under SECC are covered.<\/span><\/p>\n<\/li>\n<\/ul>\n

                  Implementation Models:<\/span><\/strong><\/p>\n

                  States have the flexibility to choose their implementation model:<\/span><\/p>\n

                    \n
                  • \n

                    Assurance\/Trust Model:<\/span><\/strong>\u00a0The State Health Agency (SHA) directly implements the scheme, reimbursing healthcare providers, with the financial risk borne by the government.<\/span><\/p>\n<\/li>\n

                  • \n

                    Insurance Model:<\/span><\/strong>\u00a0The SHA selects an insurance company to manage PM-JAY in the state, with the insurance company bearing the financial risk.<\/span><\/p>\n<\/li>\n

                  • \n

                    Mixed Model:<\/span><\/strong>\u00a0States combine both assurance\/trust and insurance models to suit their specific needs.<\/span><\/p>\n<\/li>\n<\/ul>\n

                    Financing of the Scheme:<\/span><\/strong><\/p>\n

                      \n
                    • \n

                      PM-JAY is fully funded by the government, with costs shared between the Central and State Governments.<\/span><\/p>\n<\/li>\n

                    • \n

                      The Central Government determines a national ceiling amount per family.<\/span><\/p>\n<\/li>\n

                    • \n

                      The actual premium or ceiling amount is shared between the Central Government and States\/UTs as per the extant directives.<\/span><\/p>\n<\/li>\n<\/ul>\n

                      Hospital Empanelment:<\/span><\/strong><\/p>\n

                        \n
                      • \n

                        Hospitals are empanelled through a transparent online process.<\/span><\/p>\n<\/li>\n

                      • \n

                        A State Empanelment Committee (SEC) and a District Empanelment Committee (DEC) are set up for scrutiny and verification.<\/span><\/p>\n<\/li>\n

                      • \n

                        Empanelled hospitals must have a dedicated help desk manned by Pradhan Mantri Arogya Mitras (PMAMs).<\/span><\/p>\n<\/li>\n

                      • \n

                        Hospitals are incentivized to achieve higher quality standards through higher package rates for NABH accreditation and teaching institutions.<\/span><\/p>\n<\/li>\n<\/ul>\n

                        National Health Care Providers (NHCP):<\/span><\/strong><\/p>\n

                          \n
                        • \n

                          Eminent tertiary and specialized care hospitals operating under the Ministry of Health and Family Welfare (MoHFW) are directly empanelled by the National Health Authority (NHA).<\/span><\/p>\n<\/li>\n

                        • \n

                          All NABH-accredited private hospitals in the National Capital Region (NCR) are also directly empanelled by NHA.<\/span><\/p>\n<\/li>\n<\/ul>\n

                          Expansion of Coverage and Convergence:<\/span><\/strong><\/p>\n

                            \n
                          • \n

                            PM-JAY aims to converge various state-level health insurance schemes and provide national portability of care.<\/span><\/p>\n<\/li>\n

                          • \n

                            States have the flexibility to use their own databases, expand coverage, and revise package prices.<\/span><\/p>\n<\/li>\n<\/ul>\n

                            Ayushman Bharat, with its two components of HWCs and PM-JAY, represents a significant step towards achieving Universal Health Coverage in India. By focusing on both preventive and curative care, and by providing financial protection to vulnerable populations, the scheme aims to create a healthier and more equitable society.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"Ayushman Bharat is a flagship scheme providing comprehensive healthcare through Health and Wellness Centres and Pradhan Mantri Jan Arogya Yojana, ensuring access and financial 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